The clinical course of patients with newly diagnosed heart failure varies drastically, with some patients recovering and returning to completely normal levels of ejection fraction (EF), while others develop severe symptoms of cardiac decompensation that require insertion of a left ventricular assist device (LVAD) or a cardiac transplant. Accurate risk assessment and prediction of prognosis at first presentation are crucial for appropriate allocation of therapy monitoring and patient management. Prediction tools based on standard criteria have had limited accuracy.